Claims Detail Screen
Locate the terms found in the claims detail screen.
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BRAND-NAME
DATE-OF-SERVICE
DATE-SUBMITTED
DAW-CODE
DAY-SUPPLY
DEA-CLASS
GENERIC-INDICATOR
GENERIC-NAME
GPI
MANUFACTURER
NABP
NDC
NPI
PRESCRIBER-ID
PRESCRIBER-NAME
PROVIDER-NAME
QUANTITY-DIPENSED
REJECTION-CODE
REJECTION-MESSAGE
REMAININGTROOP
RX-NUMBER
| F | J | Z | R | E | J | E | C | T | I | O | N | - | C | O | D | E | Q | Z | B |
| A | I | A | Y | I | D | A | T | E | - | O | F | - | S | E | R | V | I | C | E |
| O | T | E | P | M | E | N | E | M | A | N | - | C | I | R | E | N | E | G | C |
| N | P | G | D | C | S | F | Q | M | N | C | E | A | P | H | I | U | E | L | G |
| H | R | A | A | K | N | N | B | K | B | D | Y | T | Q | C | D | N | A | B | P |
| S | O | S | T | K | E | B | K | H | M | V | P | D | O | W | E | Y | L | B | L |
| D | V | S | E | H | P | R | E | S | C | R | I | B | E | R | - | N | A | M | E |
| D | I | E | - | Q | I | Y | J | R | V | M | E | W | I | E | R | C | F | A | Y |
| A | D | M | S | J | D | Y | D | I | R | L | T | C | E | M | O | W | N | N | H |
| Y | E | - | U | O | - | A | I | L | Y | K | - | R | M | A | N | K | P | U | L |
| - | R | N | B | E | Y | Y | W | P | G | I | Q | W | A | I | J | F | H | F | G |
| S | - | O | M | P | T | R | A | - | N | P | A | P | N | N | S | C | J | A | T |
| U | N | I | I | R | I | O | Z | D | C | H | E | A | - | I | S | P | D | C | D |
| P | A | T | T | L | T | T | I | E | P | O | T | U | D | N | A | O | I | T | U |
| P | M | C | T | A | N | C | B | L | M | Z | D | H | N | G | L | P | F | U | K |
| L | E | E | E | O | A | C | S | B | F | P | Z | E | A | T | C | B | Z | R | K |
| Y | R | J | D | T | U | X | J | U | A | Y | X | Z | R | R | - | W | S | E | B |
| W | V | E | O | R | Q | Q | B | J | J | Z | S | B | B | O | A | N | V | R | D |
| C | K | R | X | - | N | U | M | B | E | R | V | E | V | O | E | W | N | D | T |
| U | Y | D | I | - | R | E | B | I | R | C | S | E | R | P | D | C | B | L | J |
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